News Briefs: Menopause HRT; Midlife Cardiovascular Risk & Dementia; Diabetes & Prediabetes
Study Assesses Dose and Delivery Method for Menopause HRT
When it comes to assessing the risk of estrogen therapy for menopause, how the therapy is delivered—taking a pill versus wearing a patch on one’s skin—doesn’t affect risk or benefit, researchers at UCLA and elsewhere have found. But with the commonly used conjugated equine estrogen, plus progestogen (natural or synthetic progesterone), the dosage does matter. Higher doses, especially over time, are associated with greater risk of problems, including heart disease and some types of cancer, especially among obese women. The Women’s Health Initiative Observational Study (WHIOS) established the potential of estrogen therapy to increase or decrease the risk of stroke, breast cancer and heart attack, but research had never compared the risks and benefits of various formulations of estrogen treatments or delivery methods. In this new study, the team examined data from 45,112 participants in the WHIOS to gauge how various types of estrogen pills, different delivery methods (patch versus pill) and different doses of oral conjugated equine estrogen affected women’s health. Over an average follow-up of five years per patient, the researchers measured rates of adverse effects, such as coronary heart disease, breast cancer, stroke, pulmonary embolism, hip fracture, colorectal cancer, endometrial cancer and death. They found that women taking oral equine estrogen at daily doses below 0.625 mg in combination with progestogen had a lower risk of an adverse effect compared with women taking higher dosages (0.625 mg per day or more) of the same combination. Further, the risk at a daily 0.625 mg dose was greater after five or more years of use than if taken for less than five years. According to the researchers, these results could help physicians better guide menopausal women on dosage and how long to take hormone therapy. The study was published in the June 2017 peer-reviewed journal Menopause.
Midlife Cardiovascular Risk Factors May Increase Dementia Risk
A large, long-term study suggests that middle-aged Americans who have vascular health risk factors, including diabetes, high blood pressure and smoking, have a greater chance of suffering from dementia later in life. The study, published in JAMA Neurology, was funded by the National Institutes of Health (NIH). The study was led by Rebecca Gottesman, MD, PhD, professor of neurology at Johns Hopkins University in Baltimore. Her team analyzed the data of 15,744 people who participated in the Atherosclerosis Risk in Communities (ARIC) study. From 1987-1989, the participants, who were black or white and 45-64 years of age, underwent a battery of medical tests during their initial examinations at one of four centers in four different states. Over the next 25 years they were examined four more times. The researchers discovered a link between dementia and prehypertension, a condition in which blood pressure levels are higher than normal but lower than the clinical diagnosis of hypertension. “Our results contribute to a growing body of evidence linking midlife vascular health to dementia,” said Dr. Gottesman. “These are modifiable risk factors. Our hope is that by addressing these types of factors early, people can reduce the chances that they will suffer from dementia later in life.”
More than 100 Million Americans Have Diabetes or Prediabetes
More than 100 million U.S. adults are now living with diabetes or prediabetes, according to a new report released by the Centers for Disease Control and Prevention (CDC). The report finds that as of 2015, 30.3 million Americans—9.4 percent of the U.S. population—have diabetes. Another 84.1 million have prediabetes, a condition that if not treated often leads to type 2 diabetes within five years. The report confirms that the rate of new diabetes diagnoses remains steady. However, the disease continues to represent a growing health problem: Diabetes was the seventh-leading cause of death in the U.S. in 2015. About 25 percent of people over age 65 have diabetes, and nearly one in four adults overall didn’t know they had the disease, according to the study. “Diabetes is a contributing factor to so many other serious health conditions,” says Ann Albright, PhD, RD, director of CDC’s Division of Diabetes Translation. “By addressing diabetes, we limit other health problems, such as heart disease, stroke, nerve and kidney diseases, and vision loss.” The CDC’s National Diabetes Prevention Program is an evidence-based, year-long, behavior change program that helps people transition to lifelong healthier habits.
The post News Briefs: Menopause HRT; Midlife Cardiovascular Risk & Dementia; Diabetes & Prediabetes appeared first on University Health News.
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